Long COVID-19 is recognized as a condition associated with autonomic nervous system (ANS) dysfunction, yet quantitative evidence regarding its impact on integrated hemodynamic regulation during recovery from orthostatic stress remains limited. This study assessed autonomic and hemodynamic imbalance in post-COVID-19 patients by evaluating heart rate variability (HRV) and blood pressure (BP) respons-es during tilt table testing. We enrolled 61 participants, consisting of 39 Long COVID patients (Study Group, SG) and 22 healthy controls (Control Group, CG). The standardized protocol included three phases: 15 minutes of supine rest (Phase 1), 15 minutes of upright tilt at 75o (Phase 2), and 20 minutes of return to supine position (Phase 3). Pulse pressure (PP = SBP – DBP) was calculated for each phase, and baroreflex sensitivity (BRS) was derived from the ΔRR/ΔSBP ratio during phase transitions. The results indicated that SG participants exhibited autonomic dys-function during tilt. In the upright phase, they showed a blunted sympa-thetic response characterized by a significant increase in mean RR inter-vals (p=0.0136) and a decreased LF/HF ratio (p=0.0316) compared to CG. Specifically, the SG demonstrated a significantly attenuated PP re-covery when transitioning from the upright position back to the supine position (ΔPP2−3 mmHg; 95% CI: 5.6–10.4) compared to the CG (ΔPP2−3 =11.8 mmHg; 95% CI: 9.2–14.4; p=0.037). Notably, BRS values did not differ significantly between groups during this transition (p= 0.401), suggesting that fundamental baroreflex gain remains intact. In conclusion, Long COVID-19 is associated with a discoordination of integrated autonomic and hemodynamic responses to orthostatic stress. The attenuated PP recovery suggests inefficient cardiovascular compen-sation and altered vascular reactivity occurring downstream of the baro-receptor reflex arc. These findings emphasize the clinical value of com-bined tilt testing and dynamic pressure analysis in uncovering hidden dysautonomia.